Diabetes & Pregnancy

Diabetes in Pregnancy: What You Should Know

Pregnancy is an exciting time for many women. Your body and emotions undergo some amazing changes. Not only will you relish in the thrill of watching your belly grow larger and larger, but you’ll also be in awe over how fast you little one is growing inside you! All you want is to have a successful and happy outcome at the end of those 40 weeks of pregnancy.

When you’re diabetic, the excitement of pregnancy comes with some concerns and worries. You may ask yourself questions, such as “Can I continue to take my medication?” and “What lifestyle and food choices do I have to pay special attention to?”

There are two forms of diabetes that doctors and obstetricians pay attention to during pregnancy:

Pre-gestational diabetes- The expectant mother was diagnosed with diabetes (type 1 or type 2) prior to her pregnancy. Type 1 accounts for 4 percent of all diabetes in pregnancy; Type 2 accounts for 8 percent.
Gestational diabetes- Diabetes that develops during the pregnancy. It usually goes away after the baby is born. Gestational diabetes makes up 88 percent of diabetes cases during pregnancy.

Diabetes occurs when your body has difficulty producing or using insulin—the hormone that converts the sugars in the foods you eat (called glucose) into energy. If you don’t produce enough insulin, or if the insulin can’t convert glucose into fuel, high levels of glucose can build up in your blood. Your body is not able to use this glucose as a main source of energy.

Controlling your diabetes during pregnancy will decrease complications that can occur. Diabetes can increase your risk of:

Miscarriage-You are at higher risk for miscarrying if you have diabetes.
Birth defects-Babies born to diabetic mothers are at greater risk of heart defects, kidney defects, and spinal problems.
Hydramnios-A condition in which you have excess amniotic fluid surrounding your baby. Hydramnios can make it difficult for the expectant mother to breathe, because the amniotic fluid constricts her lungs. This condition can lead to preterm labor and birth defects in the baby.
Macrosomia-An overly large baby. If your baby grows too large, it may be hard to deliver vaginally. Your doctor may consider a cesarean section.
Stillbirth-Mothers who have diabetes are more likely to deliver stillbirths than women without the disease.
Respiratory distress syndrome-A breathing disorder that affects newborns, more common in premature babies than in full-term infants. Diabetes can cause your baby’s lungs to develop more slowly. If your little one’s lungs aren’t fully developed at birth, he or she can have breathing problems.
Preeclampsia-A pregnancy condition characterized by high blood pressure and the presence of excess protein in your urine. It can lead to serious (and sometimes fatal) complications for both you and your baby.

With the advances in medicine, doctors know more about diabetes now than in the past. As a result, planning your pregnancy can improve your chances of having a healthy baby.

For the best prenatal care, you should assemble a special team to monitor your diabetes during pregnancy. These individuals include an endocrinologist-a doctor that is trained to treat people with diabetes; a perinatologist-a special obstetrician who deals with high-risk pregnancies; and a dietitian or nutritionist who can help you plan your meals to ensure a balanced diet.

To control your diabetes during pregnancy, you have to pay careful attention to:

Your Diet-You may need to change your meal plan to avoid problems with your blood glucose level. Your pregnancy diet may consist of special meals or snacks that are spread over the course of the day. You may have to eat a bedtime snack to keep your blood glucose at the proper levels during the night. As your pregnancy continues, your diet may be adjusted to meet your developing baby’s needs.
Exercise-During pregnancy, exercising can decrease the amount of insulin needed to keep your blood glucose levels at normal levels. The type and amount of exercise you need depends on your health, fitness level, and how far along you are in your pregnancy. Always discuss your exercise plans with your prenatal team.
Medications-Insulin shots can help keep your glucose levels stable during pregnancy. It’s possible that you may need more insulin as your pregnancy progresses, so your dosing may change. Your prenatal team can advise you on this matter.
Blood Glucose Levels-Because your body is constantly changing as your little baby grows inside you, you will need to check your blood glucose levels multiple times through the day.